My Teneo Story; Tija Hunter, CDA, EFDA, CDIA, CDSO, MADAA
We were at CEREC 30 when Dentsply Sirona rolled out the brand new Sirona Treatment Centers, the Teneo and the Intego. As we were already in the market to add a new operatory to our office, we hit the showroom floor and within an hour, we were purchasing our brand new Teneo.
The CDC recommends that we purge our lines for 20 seconds in between each patient, that we treat our water, and test our water quarterly.
Our office prides itself on our infection control protocols and the training we take to do everything according to CDC guidelines and OSHA standards. So when it came time to test our dental unit water lines, I was skeptical about our new Teneo and how it would fare in the test.
Dental unit water line contamination is something I know about, I wrote a dental continuing education course for it and have given webinars on the subject. Testing your lines is imperative to any practice. If you treat your water, purge your lines when you should and shock your lines, how do you know what you do is working? You test! Unless you are testing, you have no idea if what system you are using, works, you are flying blind.
Standards for safe drinking water quality are established by the Environmental Protection Agency (EPA), the American Public Health Association (APHA), and the American Water Works Association (AWWA). These agencies together have established a heterotrophic bacterial count below 500 Colony Forming Units per milliliter (<500 CFU/ml) as safe for consumption. Maintaining these levels regularly ensures optimal microbiologic equality.
Dental unit water lines have long been a source of discussion and much concern. Dental unit water systems (DUWS) harbor bacterial biofilms, which is a known reservoir for pathogens.
Most of these microbes are from the public water supply and are classified as opportunistic pathogens, meaning they do not usually pose a high risk of disease for healthy person. This fact has direct implications for dentistry because increasing numbers of patients routinely seek dental treatment who have weakened immune systems. With elderly patients living longer and retaining permanent dentition, and children visiting the dentist younger, this exposure creates a heightened risk.
LEGIONNAIRES DISEASE
Legionnaires’ disease as a disease that is caused by a type of bacteria called Legionella. The bacteria got its name in 1976, when many people who went to a Philadelphia convention of the American Legion suffered from an outbreak of this disease, which is a type of pneumonia (lung infection). Although this type of bacteria was around before 1976, more illnesses from Legionnaires’ disease are being detected now. This is because we are now looking for this disease whenever a patient has pneumonia.
In February 2012, the first confirmed case of Legionnaires’ disease associated with dental water lines was reported. The patient, an 82-year-old woman in Rome, Italy, died just two days after she was diagnosed despite heavy antibiotic treatment. In the 2 to 10 days prior to onset of illness, she had left her home only twice, both times for dentist appointments. The Legionella pneumophila strain found in the dental water lines matched what was found in the patient’s body.
Since that time in 2015, we saw two outbreaks of the Legionella bacteria here in the U.S., one in Anaheim California that affected 57 children and later that year in Atlanta Georgia, 20 children were affected and in both cases, the strain of bacteria was traced back to the dental equipment were these children were seen.
OUR TEST
Our test results came back one Thursday morning about 8am, we don’t begin work until 10am on Thursdays. I was shocked when I opened the results. With seven operatories, we passed in all seven rooms, however we failed in six rooms! You see when you test, you must test each air/water syringe, each high speed handpiece line, piezo, and ultrasonic line. So you have multiple test results for each room, in all rooms I passed but in six of them I failed! Six, one room passed all of the test completely and with flying colors.
As I have already established, levels below 500 CFU’s are safe for acceptable drinking water. Our test results showed levels in all ranges. Where we failed, we had levels beyond the acceptable amount, and we needed to change our protocol and now! We successfully shocked our lines that morning before we saw patients.
But I want to talk about our room that passed, every test. And not with just numbers that barely squeaked by, in this room, we passed with numbers that shocked even us. Our Teneo Treatment Center tested out with our air/water tips at 0, a high speed handpiece line at 10, another one at 0 and the Piezo at 0. Thats after 2 years of usage!
Here I was worried sick because I couldn’t control the water supply to that room and I was worried for nothing! The Dentosept that runs through the lines, when done properly, keeps the lines clean and well maintained.
We are in the process of making plans to build a new office, and of course more Sirona Treatment Centers will be installed. When a “chair” can give you that kind of peace of mind for patient protection, why wouldn’t you invest in them? And that’s just one of the many benefits to owning Sirona equipment in your practice.
Sirona = Better, Safer, Faster!